Metacarpal cortical percentage predicts bone density and osteoporotic fracture incidence in inflammatory arthropathy patients: a retrospective cohort study

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2025-05-07 DOI:10.1007/s11657-025-01552-1

Marina A. Chimonides, Douglas J. Donnachie, David M. S. Bodansky, Pamela E. Leventis

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引用次数: 0

Abstract

Summary

Early identification of osteoporosis promotes timely treatment. This retrospective study demonstrated that bone cortical percentage (2MCP) measured on hand X-ray in patients with inflammatory arthritis correlates significantly with bone density, fracture risk and fracture incidence. Routine hand X-ray 2MCP reporting could support identification of patients at risk of osteoporotic fractures.

Purpose

Effective osteoporotic screening facilitates earlier identification and treatment of patients at risk. Bone mineral density (BMD) alone has limited sensitivity and may not always be available. This study aimed to show whether radiographic second metacarpal cortical thickness percentage (2MCP) correlates with BMD and fracture incidence.

Methods

This retrospective cohort study measured 2MCP in 230 patients with inflammatory arthropathies who underwent both DXA and hand radiograph within 6 months. BMD, FRAX and fracture history was gathered.

Results

2MCP correlated with femoral neck BMD (p < 0.001), T-scores (p < 0.001), FRAX (p < 0.001) and major and all osteoporotic fracture incidence (p < 0.001) across all patient groups. 2MCP ≤ 55% was 88% sensitive and 51% specific in identifying patients with osteoporotic BMD (AUC 0.7893). 2MCP ≤ 65% and ≤ 73% were 100% sensitive for osteoporotic and osteopenic BMD respectively, whilst ≤ 30% and ≤ 39% were 100% specific. 2MCP ≤ 59% demonstrated 92% sensitivity for all low-impact fractures and 2MCP ≤ 56% was 87% sensitive for major osteoporotic fracture (MOF). 2MCP showed superior sensitivity and specificity to osteopenic femoral neck T-score for predicting MOF incidence (AUC 0.7009 and 0.6590). Combining 2MCP with T-score parameters enhanced sensitivity to 94.6% for MOF up to 2 years beyond the hand radiograph.

Conclusion

2MCP presents a fast, inexpensive adjunct to evaluate fracture risk. This technology may enhance BMD sensitivity in predicting MOF and improve global bone health assessment accessibility. 2MCP automation and routine inclusion in hand radiographs could optimise early awareness and diagnosis of patients at risk of osteoporosis and fractures.

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掌骨皮质百分比预测炎症性关节病患者的骨密度和骨质疏松性骨折发生率：一项回顾性队列研究

骨质疏松症的年度诊断有助于及时治疗。本回顾性研究表明，炎症性关节炎患者手部x线测量的骨皮质百分比（2MCP）与骨密度、骨折风险和骨折发生率显著相关。常规手部x线2MCP报告可支持骨质疏松性骨折风险患者的识别。目的有效的骨质疏松症筛查有助于早期识别和治疗有风险的患者。骨矿物质密度（BMD）单独具有有限的敏感性，可能并不总是可用的。本研究旨在显示放射学第二掌骨皮质厚度百分比（2MCP）是否与骨密度和骨折发生率相关。方法本回顾性队列研究测量了230例炎性关节病患者的2MCP，这些患者在6个月内接受了DXA和手部x线片检查。收集BMD、FRAX和骨折历史数据。结果2mcp与股骨颈BMD （p < 0.001）、t评分（p < 0.001）、FRAX （p < 0.001）、主要骨质疏松性骨折发生率及所有骨质疏松性骨折发生率均相关（p < 0.001）。2MCP≤55%鉴别骨质疏松性骨密度的敏感性为88%，特异性为51% （AUC为0.7893）。2MCP≤65%和≤73%对骨质疏松和骨质减少BMD的敏感性分别为100%，特异性分别为≤30%和≤39%。2MCP≤59%对所有低冲击骨折的敏感性为92%，2MCP≤56%对主要骨质疏松性骨折（MOF）的敏感性为87%。2MCP对股骨颈t评分预测MOF发生率的敏感性和特异性均较好（AUC分别为0.7009和0.6590）。将2MCP与t评分参数相结合可将MOF的灵敏度提高到94.6%，超过手部x线片检查2年。结论2mcp是一种快速、廉价的评估骨折风险的辅助手段。该技术可提高BMD预测MOF的敏感性，提高全球骨健康评估的可及性。2MCP自动化和常规纳入手部x线片可以优化骨质疏松和骨折风险患者的早期认识和诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.